Transforming Treatment for Acute Malnutrition health

Transforming the way acute malnutrition is treated to save lives and cost

IRC is proposing a suite of five approaches to simplify treatment for acute malnutrition and to make it more accessible. Alongside an ambitious advocacy campaign, they have the potential to transform the way children with acute malnutrition are treated.
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education

EdTech Global Landscape Analysis

The research identified six EdTech innovation trends that represent patterns of approach we observed across many individual global projects. Accompanying each innovation trend are 2-3 case studies that illustrate how...

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economic-wellbeing

Local Manufacturing of Medical Supplies in Northwest Syria

Northwest Syria

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empowerment

Service Delivery for Mobile Populations

Jordan

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empowerment

Urban Housing

Jordan

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This project became inactive following the Design Research phase

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innovative-finance

Crisis Risk Finance

Global

IRC’s work on crisis risk finance seeks to develop a blueprint for how organizations can reorient more of their resources and processes to be better prepared for, and how the...

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innovative-finance

Defining and driving innovative finance

Global humanitarian budgets are not keeping pace with our clients’ needs and aspirations. Airbel is designing and testing new approaches to raising finance, and impactful new ways to use funds...

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innovative-finance

Financing Refugee Crisis Response

Together with the Centre for Global Disaster Protection, Airbel is working to assess the potential to use risk-based financing approaches to respond to refugee influxes.

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This project graduated following the Generate Solutions phase

education

Humanitarian EdTech Innovation Toolkit

The toolkit is developed for organizations in the humanitarian sector seeking to improve the education access and quality for crisis-affected communities via technology-enhanced solutions.

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empowerment

Information Flows

Jordan

Displaced people live in challenging circumstances where accurate information can become difficult to obtain. Strengthening information flows can aid in decision-making and make their circumstances easier to manage.

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This project graduated following the Generate Solutions phase

empowerment

Placement Algorithm

United States

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This project became inactive following the Generate Solutions phase

economic-wellbeing

Trade Accelerator

Focused support for Jordanian businesses to foster rapid growth and help them tap into the European market and hire refugees to do so.

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This project became inactive following the Generate Solutions phase

health

Virtual Baby

This portable game would let children earn points for raising a happy baby, teaching them about sexual health and nutrition.

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This project became inactive following the Generate Solutions phase

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empowerment

Ask Laila

A hotline, SMS, and web-based service to help resettled refugees get quick answers from a trusted local source - in their own language.

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This project became inactive following the Prototype phase

education

Audio-Class System

Colombia

The Colombian education system is struggling to support an unprecedented influx of students in the midst of a global pandemic. To respond to the crisis, the IRC created an innovative...

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health

Dela

Liberia, Democratic Republic of Congo

Dela aims to be an open-source mobile application that connects community health workers and their supervisors with a consistent channel of communication, to improve the quality of services delivered through...

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empowerment

Games for Diversity and Inclusion

Airbel worked closely with colleagues in the Asia Region to prototype approaches to increasing diversity and inclusivity in our workplaces through mechanisms with wide appeal, that can be easily integrated...

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This project graduated following the Prototype phase

health

Medicine Bank

Jordan

People with low income in Jordan often struggle to access the medicine they need. This solution is aimed at making supply chains more efficient to reduce the cost of pharmaceuticals....

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InforMH

Jordan

Leveraging people’s existing practices to bridge the information and stigma gaps that prevent people from seeking mental health and psychosocial support.

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health

Sprout

Niger

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This project graduated following the Prototype phase

education

Spark

Tanzania

Spark creates alternative learning spaces outside of refugee camp schools to practice play-based learning and social-emotional skills with primary school children.

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This project became inactive following the Prototype phase

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empowerment

IRC Connect

United States

In partnership with Twilio.org, Airbel is developing an SMS-based system to streamline communication between caseworkers and newly-settled refugees as they adapt to their new lives in the United States.

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This project graduated following the Pilot phase

education

Coach Erevu

Tanzania

Coach Erevu is a virtual teacher coaching program designed to empower teachers to learn and practice social-emotional learning activities that they can use in their classrooms.

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This project graduated following the Pilot phase

health

Low-Literacy Malnutrition Tools

South Sudan

In hard-to-reach areas local community health workers are key to treating malnourished children. Commonly used tools for diagnosing and treating malnutrition have been adapted to meet the needs of workers...

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This project graduated following the Pilot phase

economic-wellbeing

Impacts of anticipatory cash to small-holder farmers and livestock owners in Northeast Nigeria

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health

Micronutrient Condiment

Kenya

Two billion people are affected by micronutrient deficiencies worldwide. One third of them are children. We aim to introduce an affordable product inspired by existing porridge preparation practices for sale...

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education

PlayMatters

Ethiopia, Tanzania, Uganda

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education

Pop-Up Class Tanzania

Tanzania

Pop-Up Class Tanzania is an after-school digital learning program where children learn on personalized game-based learning software called onecourse and Kitkit School.

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education

Pop-Up Learning Tanzania

Tanzania

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innovative-finance

Resettlement Revolving Fund

In this new model for refugee resettlement finance, a self-sustaining fund provides countries with finance for refugee resettlement, and is replenished as refugees fuel economic growth.

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This project graduated following the Pilot phase

economic-wellbeing

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Syria, South Sudan, Pakistan, Niger

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education

Tunakujenga

Tanzania

Tunakujenga is a family learning program designed to empower caregivers to engage in nurturing and playful parenting to support their children’s social and emotional development.

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This project graduated following the Pilot phase

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education

EmpaTeach

Tanzania

EmpaTeach is a project that aims to reduce corporal punishment in low resource settings by helping teachers learn positive discipline methods, change destructive thought patterns, and plan ahead for positive...

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This project graduated following the Rigorous Evaluation phase

safety

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Liberia, Uganda, Peru

The Real Man Challenge is a mobile messaging campaign that engages men with an aspirational and positive masculine identity to prevent intimate partner violence. It sends WhatsApp messages to men...

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education

Pop-Up Learning Bangladesh

Bangladesh

Pop-Up Learning is a tablet-based computer-assisted learning program, aimed to mobilize quickly and efficiently on the onset of crisis.

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safety

Becoming One

Uganda

Becoming One is a counseling program designed to bring couples closer and prevent intimate partner violence. The program is delivered in partnership with local faith leaders, who guide couples through...

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health

ComPAS: Combined Protocol for Acute Malnutrition Study

South Sudan, Kenya, Somalia, Mali, Chad

The current malnutrition treatment is inaccessible for 4 out of 5 acutely malnourished children globally. A new combined approach is simpler, less expensive, & offers more comprehensive treatment, with the...

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other

Dioptra

Dioptra simplifies the process of conducting cost analyses, helping humanitarian and development actors make use of limited resources in a transparent and effective way.

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economic-wellbeing

Match

Jordan

Working to counter the high rates of unemployment that follow mass displacement, the Match project in Jordan is testing a set of new innovations for placing vulnerable populations and refugees...

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education

Ahlan Simsim

In this historic effort, IRC and Sesame Workshop have partnered to help children whose lives have been uprooted by the war in Syria to build brighter futures.

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Acute malnutrition is a continuum condition meaning a child’s condition improves or deteriorates continuously along a single spectrum. Today, children suffering from acute malnutrition are divided into two different categories based on the severity of their illness: severe acute malnutrition (SAM) and moderate acute malnutrition (MAM).  This impacts what kind of treatment they access, where treatment is available to them, and far too often, whether they can access treatment at all. 

Treatment for SAM and MAM is rarely available at the same place and time and in many locations, treatment for MAM is not available at all, meaning children must wait until their health deteriorates before accessing the care that they need. Worse still, the treatment for both conditions is currently available only in formal health facilities putting the burden on families to traverse long, often dangerous distances, to reach the life-saving care their children desperately need.  

This system is inefficient and makes it difficult for children to access the care they need.  In fact, less than 20% of acutely malnourished children receive the treatment they need to fully recover. 

The five interventions

  1. Combined, simplified treatment of SAM and MAM: Under a combined approach, children with SAM and MAM are treated together in the same physical location, using a tailored dose of one product. This is simpler for health providers to implement and relies on fewer treatment products to deliver the same health gains. 
  2. Delivering Care Through Community Health Workers (CHWs): TheIRC has piloted and tested the feasibility of delivering treatment through community health workers, which enables families to access care directly in the communities they live from providers they know. The IRC designed and developed simplified tools to support even low-literate CHWs to accurately diagnose and treat acute malnutrition.
  3. Parents Monitoring and Diagnosing Malnutrition at Home: Several clinical trials and operational studies have shown caretakers can be trained to accurately diagnose malnutrition in their own children. Empowering caretakers to manage the screening process allows children to be identified and referred to care more quickly.
  4. Locally-sourced and Produced Ready-to-use Foods: Ready-to-use food (RUF) makes it possible for children to be treated in their own homes. These products are typically produced in/shipped from Europe and the United States. Locally-sourced and produced RUF would allow more children to be treated for less cost.
  5. Integrating Treatment and Prevention: The IRC is testing a series of strategies to prevent malnutrition in vulnerable communities. The next step is integration – linking families of malnourished children with resources to prevent malnutrition from reoccurring.

Where we are now

The IRC is generating evidence around these innovative approaches. Our research and pilot studies already suggest that these approaches are feasible and can have a transformative impact on the lives of children around the world. 

The IRC is also leading and ambitious advocacy campaign to ensure these approaches will be endorsed, adopted into policies and guidelines, and adequately financed. This requires elevating acute malnutrition as a priority for global donors, targeting stakeholders from peer organizations, and working directly with the U.N. to build the consensus and political will needed to see these approaches put into action.

March 2023 | We have now treated over 100,000 children with the simplified protocol across multiple countries, building a strong evidence base on effectiveness and cost-effectiveness of simplified approaches in many contexts.

We will be combining our database - which has detailed, patient-level data, with those from our partner organizations, Action Against Hunger and Save the Children, this year. By combining data, we’ll be able to conduct rapid analyses on the simplified protocol to answer new research questions and support policymakers.

November 2022 | Published an effectiveness study from our operational research Mali in Nutrients, a peer-reviewed journal

This study reviewed results from over 27,000 patients treated with the simplified protocol since 2018. The results were very strong. We demonstrated that the simplified protocol is highly effective – patients had an overall recovery rate of 92%, a mean length of stay (the amount of time in treatment) of 40 days, and a mean RUTF consumption of 62 sachets. We also demonstrated that Community Health Worker (CHW) delivery of treatment is just as effective as care in a health facility, and makes treatment more accessible – CHWs recovered patients at a 94% rate.

Resource

January 2021 | Developed a UNICEF partnership to scale up simplified approaches and are now leading a consortium of our team, Action Against Hunger, and Save the Children

This represents the first time UNICEF invested in simplified approaches and concretely supported uptake through needed technical assistance, evidence generation, implementation, and innovation.

December 2020 | Published research in peer-reviewed journals, contributing to our evidence base.

We shared the outcomes from our randomized controlled trial (RCT) on the simplified protocol in PLOS One and PLOS Medicine. These findings validate the safety, feasibility, and cost-effectiveness of our approaches, and support our national and global advocacy.

July 2019 | UN issues joint statement on wasting

UN leaders publically committed to developing a Global Action Plan on Wasting and to updating WHO treatment guidelines. This commitment represents critical progress toward policy reform. The IRC played a key role in generating the political will needed to make this statement.

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October 2018 | Multi-country pilot begins

In Mali and Chad, UNICEF, WFP and ECHO endorse the combined protocol for further exploration and unite to fund and organize a large-scale, multi-country pilot of the combined protocol. These pilots will generate additional evidence from which the IRC will drive meaningful policy change and produce programmatic guidance. 

August 2018 | Randomized control trial in Kenya and South Sudan concludes

Working closely with partners Action Against Hunger and the London School of Hygiene and Tropical Medicine, the IRC implemented a randomized controlled research study (RCT) in Kenya and South Sudan to test a combined protocol to treat children with SAM and MAM. Preliminary results from the trial suggest that the combined protocol is not only successful at recovering children with both SAM and MAM to full recovery, but can do so at a lower cost.

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March 2018 | Conclusion of test of severe acute malnutrition protocol in Somalia

The IRC conducted a prospective cohort study to test an adapted protocol for treating SAM in Somalia using RUTF dosage based on the treatment protocol implemented in the ComPAS research trial in Kenya and South Sudan. To further understand requirements for adaptation and adoption of the combined protocol in different contexts, the IRC also conducted a policy analysis on the use of the protocol in five different food-crisis affected contexts. 

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September 2017 | Study on delivering care through community health workers concludes

The IRC has piloted and tested delivering treatment through community health workers which enables families to access care directly in the communities they live, from providers they know. To make this feasible, the IRC designed and developed simplified tools to support even low-literate CHWs to accurately diagnose and treat acute malnutrition.

Resource

January 2016 | Design of combined, simplified protocol concludes

Working with an expert task force of scientists at the London School of Hygiene and Tropical Medicine, Washington University School of Medicine, and University of Tampere/University of Copenhagen, the IRC conducts secondary data analysis of 10,000 acutely malnourished children to propose a new optimized dosage of RUTF to treat SAM and MAM. 

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October 2014 | Design of combined simplified protocol begins

The Airbel Impact Lab at IRC is a team of researchers, strategists and innovators committed to the accelerated design, rigorous evaluation and cost-effective scaling of the most impactful solutions supporting people affected by crisis.